Filling out a referral for a preliminary medical examination. Referral form for a medical examination (medical examination) from the employer

Mandatory medical examinations are required for certain categories of employees. At the same time, there are various types of inspections - preliminary, periodic, during the day. To undergo them, the employee must provide a referral from the employer to the medical institution.

A referral for a medical examination is a mandatory document and is issued to an employee each time a medical examination is required. The features and procedure for undergoing a medical examination are prescribed in Order No. 302n dated April 12, 2011. We also suggest that you read on this topic.

Attached to this order is a standard referral form for a medical examination, which can be used to fill out. The document is filled out at the time a specific employee is sent for a medical examination and given to the employee. The referral must be presented to the medical institution with which the employer has an agreement for the provision of medical services. Pays the costs of these services to the employer in relation to those employees for whom mandatory examinations are established at the legislative level.

We offer a download of a sample referral for a medical examination from Order No. 302n in this article below. Also, as an example, we filled out this form when sending an employee for preliminary and periodic examinations. You can also download sample forms at the end of the article for free.

Sample design

Order No. 302n specifies specific requirements for the content of a referral for a medical examination, that is, those items that must be included in this form:

• information about the person who is the employer. Details must include the full and abbreviated name of the company, form of ownership and type of activity in accordance with the OKVED classifier;
• information about the medical institution with which the agreement for services was concluded (its name, address, OGRN);
• type of medical examination - preliminary upon hiring or periodically, carried out during the work process;
• information about the person in respect of whom the inspection should be carried out;
• position and nature of work duties performed;
• facts indicating the degree of danger of the work performed, as well as the degree of its harmfulness.

After filling out the direction, it must be signed; the signature of the director or the person authorized to do so by order of the director or power of attorney to represent interests is affixed.

To record referrals, you should keep a journal in which registration entries are consistently made about the documents issued, recording information about the employee, the purpose of the examination and the details of the referral itself.

A referral for a medical examination is issued to the employee to undergo mandatory medical examinations organized by the employer. Find out how to format this document correctly, download a sample.

From the article you will learn:

In what cases is a referral for a medical examination issued from the employer?

Medical examination and medical examination when obtaining permission to drive vehicles or carry weapons are not related to Article 213 of the Labor Code of the Russian Federation; the employer does not pay for them. The employer is obliged to conduct preliminary and periodic medical examinations and mandatory psychiatric examinations, as well as pre-trip, pre-shift and, in some cases, post-shift and post-trip.

A referral to a medical institution is issued by the employer upon hiring, as well as during periodic medical examinations. The medical commission takes this document from the employee and attaches it to its documentation.

Before hiring, the employer must make sure that the candidate meets the requirements of the profession in terms of his health, has no contraindications, and does not already have illnesses that prevent him from being hired. The personnel specialist receives information about whether the candidate is eligible for a preliminary medical examination from the list of contingents that provides. The list of contingents contains all the information necessary to fill out the referral.

How to fill out a referral form for a medical examination, Form 302 n

The employer must agree to conduct a preliminary and periodic medical examination. This organization is indicated in the direction. The list of details contains the name of the medical institution, its OGRN, etc.

The referral for a medical examination should contain only the information necessary for the medical organization on working conditions and harmful production factors. Based on them, the medical commission will determine what examinations and tests must be performed to obtain a complete picture of the employee’s health and determine his ability to work in the specified type of activity.

It is imperative to list the harmful and dangerous factors present in the workplace. In the contingent list, these factors are indicated in the corresponding column. There is no need to rewrite the entire factor; it is enough to write the corresponding paragraph or subparagraph from both appendices to order No. 302n. In line 040 of the SOUT cards, the grounds for medical examinations are noted, but if a SOUT declaration has been drawn up for the workplace, you should check the grounds according to Appendix 2 in Order 302n.

Finding a reliable provider of medical examination services is not easy. In small towns and villages, hospitals do not always dictate legal conditions. There are many scammers among those who offer medical services in big cities. How to avoid relationships with unscrupulous organizations and where to check your counterparty - read in the magazine "Handbook of Occupational Safety and Health Specialist".

A referral for a medical examination is issued to the person applying for work in hand against signature and strictly individually. It cannot be passed on through other employees, etc. The form contains the employee’s personal data. This document is also issued when. Refusal to undergo a medical examination means failure of the applicant or employee to fulfill their obligations, as a result of which the employment contract is not signed, and if it has already been signed, it must be terminated.

If the applicant, on his own initiative, applied with an issued referral to another medical organization, the employer must assess its risks if it refuses to pay for a medical examination for such unauthorized actions. If payment is refused, the employee may apply to the State Tax Inspectorate, the prosecutor's office or the court to protect his interests.

The applicant can pay for the medical examination from his own funds and present the employer with an invoice for payment and a medical report drawn up by a licensed medical organization in the scope of the factors specified in the referral. If the conclusion is not fully drawn up based on these factors, or the organization does not have a license, such a conclusion is not accepted and the procedure is not paid for.

When all the requirements for conducting a preliminary medical examination are met, you need to accept the conclusion and pay. The obligatory condition has been fulfilled by the employee - the examination has been completed strictly according to the list of factors at his workplace and in a medical institution licensed to conduct preliminary and periodic medical examinations.

The logbook for issuing referrals for medical examination is compiled in any form. The main details are the employee’s signature on receipt and the date of issue, as well as a list of VOPF.

Sample referral for a medical examination from an employer

There is no approved form of the document. establishes a list of GPPFs that are the basis for referral for a medical examination, as well as the Procedure for conducting preliminary and periodic medical examinations.

Employees of those enterprises and specialties for which the process of undergoing a medical examination is mandatory must certainly go to the relevant institutions for preliminary or primary medical examinations, as well as undergo periodic examinations in accordance with the order of their completion. Moreover, this procedure is carried out at the expense of the employer on the basis of a referral issued by him for a medical examination from the order of the Ministry of Health 302n dated April 12, 2011.

Before carrying out the medical examination procedure itself, each employer is obliged to give its employees the necessary directions, which are issued to everyone against signature, and are subject to accounting by the employer himself. The document in question is a standard sample referral from an order with form 302n, which the employee is obliged to submit to a medical institution and undergo the necessary doctors.

Depending on the information message specified in the referral, certain health workers and specialists will be assigned, and appropriate tests will be prescribed if necessary.

The form of referral for a preliminary or periodic medical examination is taken from the appendix to order 302 n.

The procedure for registering a referral for a medical examination is clearly detailed in Order No. 302n. Must be indicated:

• all data about the company itself that offers the job. That is, the name of the company, its form of ownership, as well as OKVED, and the like;
• all information about the medical institution with which the company has entered into an agreement for the provision of such medical services. The name of the clinic, its address, as well as the OGRN must be indicated;
• type of medical examination to be completed - periodic or preliminary examination;
• information about the employee who must undergo such an examination;
• position or type of activity of the employee.

Also, in direction 302n, all hazards and hazards that are established for a specific position or for certain types of work must be indicated. In this case, the drawn up referral form for periodic or preliminary medical examinations is signed by a certain person of the company or organization who represents its interests in this direction.

Who should undergo a medical examination

A referral for a preliminary medical examination is issued in accordance with the provisions of Law 302n, which clearly states that such an examination is necessary:

• if there are dangerous and harmful production factors;
• for hazardous types of work;
• when the employee’s position involves interaction with children;
• for health workers;
• for those in contact with products;
• employees under 18 years of age;
• working in waterworks.

Note: Medical examination for these categories of employees is paid for by the employer. Expenses can be taken into account in tax and accounting.

Why do you need a medical examination?

Based on the results of the preliminary medical examination, the employee at the medical center will be given a special document, which the person must provide to the employer. A sheet filled out by doctors allows the latter to determine the level of health of a potential employee and understand whether a candidate for a vacancy can perform the tasks assigned to him without much harm to his health.

In order for the entire procedure to take place in a certain order, a special legislative document is provided in the form of an order numbered 302n dated May 17, 2016. This document clearly states for which persons it is necessary to undergo a medical examination, and this document also defines a clear procedure for carrying out the entire procedure. In addition, the order has a standard referral form attached that can be used to fill out.

Below we offer you to download a sample of filling out a referral for both periodic and preliminary medical examinations.

In accordance with the rules, all enterprises must have a standard format direction from Order 302n available. The employer must also have a list or list of those persons who are required to undergo all necessary medical examinations. In addition, anyone who needs to undergo such medical examinations must be notified in advance that they need to go to a medical facility for the necessary examinations, and they must also be notified of the frequency of such examinations. In this case, the list is the basis for issuing a referral to the employee to undergo a medical examination.

When hired to work in a company with a certain field of activity, some employees must undergo an initial mandatory medical examination. To do this, the employer fills out the appropriate document - a referral according to the standard sample according to order 302n. This form is filled out by employers to undergo any type of medical examination - initial upon entry to work, periodic.

The need to visit a medical institution in order to undergo a periodic medical examination arises not only when applying for a job, but also during labor activity. The frequency of such events is determined individually in each case. When preparing a referral, it is important to follow all the necessary rules for its preparation. Otherwise, the medical institution has the right to refuse admission to citizens.

How to refer for a medical examination

The procedure for undergoing a medical examination is regulated by the current legislation of the Russian Federation. For this purpose, a special order was issued - No. 302n. It contains information on how to submit a referral for a medical examination from an employer, as well as which categories of employees require initial and periodic examinations.

The internal documentation of each company must contain a paper that contains information about employees whose work activities require them to undergo periodic medical examinations. In this case, each of these employees is sent advance notice of the upcoming event.

Download a standard current referral form from Order 302n, as well as a sample of filling out a document from an employer for an initial and periodic repeated medical examination in the article below.

How to fill out a referral for a medical examination using Form 302n in 2017 - 2018

The form form from the order of the Ministry of Health and Social Development looks like this:

In accordance with Order No. 302n, the following information must be included in the medical direction:

• information about the employer. Name of the organization, current form of ownership, address and contact telephone number;
• information about the institution with which the company has entered into an agreement for the provision of medical services. Name, address, contact phone number and OGRN;
• type of medical examination - primary or periodic;
• information about the employee - full name, position held;
• type of work activity and work performed;
• hazards and dangers present at work;
• Full name and signature of the responsible person who issued the referral.

When drawing up the form, the employer does not have to use the form established by Order 302n from Appendix 2. Another design option is allowed. This is only possible if the referral to the medical commission indicates the basic information that should be present in it.

It is important to take into account that the order and date of medical examinations is quite an important point. To record information about these events, each company must have a special journal. In it, the responsible employee makes the appropriate notes upon the issuance of a referral for a medical examination.

It is mandatory to undergo a periodic medical examination

The Labor Code of the Russian Federation defines categories of working citizens whose specific professional activities oblige them to periodically visit medical institutions in order to undergo certain tests and undergo medical examinations. In this case, the employee must undergo a primary medical examination upon entering work; the referral is issued at the place of work. The employer does not have the right to allow a person to work until he brings a certificate of successful completion of a medical examination.

The following officially employed citizens undergo mandatory periodic medical examinations:

• persons under the age of majority;
• food industry workers whose activities involve constant interaction with food;
• employees operating vehicles - drivers;
• health workers;
• citizens working in enterprises in which there is a factor of harmfulness and danger.

The main purpose of periodic and primary medical examinations is to monitor the health status of workers. If a medical examination reveals diseases, including those of a contagious nature, the employee is not allowed to work. In the event that a medical examination determines a tendency to diseases associated with professional activity, a working citizen can be transferred to light work.

Sample directions to periodic medical examination:

You can download this sample in Word below.

Features of the primary medical examination

An employer can issue a referral for a primary medical examination to almost any employee. This event has the following goals:

• assessment of the citizen’s health status and its compliance with working conditions;
• determining the presence of diseases in the early stages of their development;
• protecting the health of people working at the enterprise.

The referral is issued to the employee by the employer until an employment contract is concluded with him. The procedure for preparing this document is described in the order of the Ministry of Health and Social Development No. 302n. In accordance with the information contained therein, the forms for filling out referrals for initial and periodic examinations are almost the same. The only difference is the nature of the medical examination.

Sample referrals for mandatory medical examination when applying for a job:

Consequences of not having a medical examination

It is important to take into account that if an employee who has not passed a medical examination is allowed to work, the employer may face an administrative fine. This rule is relevant if an employee who does not have an appropriate conclusion belongs to the category of citizens subject to mandatory health examination.

If, based on the results of a medical examination, a citizen cannot occupy the position for which he is applying, the employer has the right to offer him another vacancy. If such a circumstance arises during a periodic examination, the employee may be dismissed. At the same time, the company pays him severance pay.

Who pays for medical examination services?

All expenses are borne by the employer. If the law provides for the mandatory sending of personnel for medical examinations, both initial upon hiring and periodic, then these expenses can be taken to reduce the income tax base.

Sometimes the employer, on his own initiative, sends the citizens he hires for a health check; such expenses cannot be taken into account for tax purposes.

Sample filling 2017 - 2018

Download the referral form for a medical examination (form from order 302n) - .

Download a sample referral form for the initial mandatory examination upon hiring - .

Download a sample of filling out a referral for a periodic medical examination - .

Questions and answers

Question 1: The organization accepted students for internship without an employment contract. The work where the internship will take place has hazardous working conditions, and a medical examination is required. Do trainees need to be sent for a medical examination?

Answer: Yes, it is necessary, even without concluding an employment contract.

Question 2: A foreign citizen who has already passed a medical examination when obtaining a patent is hired for a job that requires a mandatory primary medical examination. Do I need to refer him to doctors again when he starts work?

Answer: Yes, it is necessary if the position for which a foreigner is hired requires a medical certificate.

Question 3: The employer employs disabled people. Do they need to be sent to a medical commission?

Answer: If their profession is not included in the list of those for which medical examinations are mandatory, then they do not need to be sent. That is, the fact that an employee has a disability does not oblige the employer to issue a referral.

Question 4: The citizen being hired went through the commission at his own expense and brought a certificate in the required form. The employer reimbursed the costs of the medical examination. Does the employer need to send the employee for an initial examination again? Will there be a violation here? The employee and employer have no claims against each other.

Answer: Despite the fact that the employee being hired has brought a medical certificate, the employer is obliged to send him for an initial examination - this is his obligation under labor law. If this does not happen, the employer may be subject to administrative liability.

Do you have any questions? Ask them in the comments below and get a free answer from our expert!

Examinations and psychiatric examinations for certain categories of workers (paragraph 4, part 2, article 22 and paragraph 12, part 2, article 212 of the Labor Code of the Russian Federation). Let's talk about the documents required for mandatory But first, about the types of medical examinations.

Types of mandatory medical examinations

Mandatory medical examinations can be subdivided (Part 1 of Article 213 of the Labor Code of the Russian Federation):

For preliminary purposes - before hiring, assess the health status of the future employee and the possibility of him performing his professional duties (Articles 213, 298, 324 and 330.3 of the Labor Code of the Russian Federation);

Periodic - during work, reduce the risk of occupational diseases in workers due to the fault of the employer (Article 213 of the Labor Code of the Russian Federation);

For whom is it required?

Lists of harmful labor factors and types of work for which a mandatory medical examination is carried out are given in Order No. 302n of the Ministry of Health and Social Development of Russia dated April 12, 2011 (hereinafter referred to as Order No. 302n).

Confirmation of harmful factors by special assessment

Harmful factors are confirmed:

Special assessment of working conditions (Part 1, Article 3 of the Federal Law of December 28, 2013 No. 426-FZ “On Special Assessment of Working Conditions”). This procedure was introduced on January 1, 2014;

According to working conditions, carried out before January 1, 2014. Let us remind you that the results of workplace certification can be used for five years, but no more than until December 31, 2018 (Part 5, Article 15 of the Federal Law of December 28, 2013 No. 421FZ).

What harmful factors do not need to be confirmed by a special assessment?

The List of harmful and (or) dangerous production factors, in the presence of which mandatory preliminary and periodic medical examinations are carried out, indicates:

Factors classified as harmful and (or) dangerous based on the results of certification of workplaces for working conditions or a special assessment of working conditions;

Factors that, by the level of their impact, are classified as harmful and (or) dangerous classes in accordance with current regulations, regardless of the results of certification of workplaces for working conditions or a special assessment of working conditions.

This is stated in the letter of the Ministry of Labor of Russia dated March 21, 2014 No. 15-2/OOG-242.

Among the harmful factors that do not require confirmation is the electromagnetic field of the broadband frequency spectrum from a PC when working at a computer for at least 50% of the working time. This harmful factor of working conditions is in paragraph 3.2.2.4 of Appendix No. 1 to Order No. 302n.

Thus, if an office employee spends more than 50% of his working time working on a computer, the company is obliged to send him for mandatory medical examinations, namely:

Preliminary (upon hiring);

Periodic (every two years).

Moreover, this obligation is not related to certification or special assessment of workplaces based on working conditions (letter of the Ministry of Labor of Russia dated March 21, 2014 No. 15-2/OOG-242).

Periodic medical examinations

The procedure for conducting periodic medical examinations is given in Appendix No. 3 to Order No. 302n (hereinafter referred to as the Procedure for Conducting Medical Examinations). It is illustrated in the diagram.

Scheme Sequence of actions during periodic medical examination

Contingent list

Composition of indicators of the contingent list. The list of employees subject to preliminary and periodic medical examinations indicates:

Name of the employee’s profession (position) according to the staffing table;

Name of the harmful production factor.

Source of information about the names of harmful factors. The names of harmful production factors are listed in Appendix No. 1 to Order No. 302n.

In addition, the list contains the names of harmful factors that have been identified:

Based on the results of certification or special assessment of workplaces based on working conditions;

Research and testing obtained as part of control and surveillance activities, production laboratory control;

In operational, technological and other documentation for machines, mechanisms, equipment, raw materials and materials used by the employer in carrying out production activities.

This is stated in paragraph 20 of the Procedure for conducting medical examinations.

Making a list. The list of contingents is drawn up in any form. It is approved by the company.

Please note: if your company has professions for which harmful factors are not established by Order No. 302n, such employees do not need to be sent for a medical examination.

The letter indicates the name of the company, the documents to be sent, required for the mandatory medical examination and their quantity.

Where and when to send the contingent list

Commercial organizations send the approved list of contingents to the local office:

Federal Service for Consumers and (Rospotrebnadzor);

Federal Medical and Biological Agency, if the company or the territory in which it is located is indicated in Order of the Government of the Russian Federation dated August 21, 2006 No. 1156-r.

This conclusion follows:

From paragraph 21 of the Procedure for conducting medical examinations;

Clause 3 of the Regulations on the Federal State Sanitary and Epidemiological Surveillance, approved by Decree of the Government of the Russian Federation dated 06/05/2013 No. 476.

The list must be sent within 10 days of approval.

Agreement with a medical organization

The medical organization in which your company’s employees will undergo a mandatory medical examination must meet certain conditions (clauses 4 and 5 of the Procedure for conducting medical examinations):

Have a license for this type of service; - it must have all the necessary doctors and equipment to conduct mandatory research.

The start (end) date of the medical examination of employees is agreed upon with the medical organization.

Compiling name lists of employees

Name lists are compiled on the basis of an approved list of employees. The list of names indicates (clause 22 of the Procedure for conducting medical examinations):

Last name, first name, patronymic, profession (position) of the employee subject to periodic medical examination;

Name of the harmful production factor or type of work;

Name of the employer's structural unit (if any).

Name lists must be approved and submitted to the medical organization no later than two months before the start date of the periodic examination, agreed upon with the medical organization (clause 23 of the Procedure for conducting medical examinations).

Schedule of medical examinations

After receiving the name list of employees, a medical organization must, within 10 days, develop and submit to the employer for approval a calendar plan for conducting a medical examination (clause 25 of the Procedure for conducting medical examinations).

The company introduces employees to the calendar plan

The employer is obliged to familiarize employees who are subject to periodic medical examination with their signature, with the calendar plan for its implementation. This must be done no later than 10 days before the start date of the medical examination agreed upon with the medical organization (clause 26 of the Procedure for conducting medical examinations).

Specify the period of the medical examination;

List the employees who need to undergo a medical examination. If the list is large, it can be included in the appendix to the order;

Period of medical examination.

Referral for medical examination

Before conducting a medical examination, it is necessary to give the employees directions (clause 24 of the Procedure for conducting medical examinations). They are designed in any form. The list of details for referral for a medical examination is established in paragraph 8 of the Procedure for conducting medical examinations. A sample document is provided below. Order No. 302n does not say about the exact timing of issuing directions. It would be logical to issue directions to employees at the time of familiarization with the calendar plan for conducting a medical examination.

Employee documents for medical examination

List of documents. When undergoing a medical examination, the employee submits the following documents to the medical organization (clause 9 of the Procedure for conducting medical examinations):

Direction;

Passport (or other document proving his identity);

Employee health passport (if available);

The decision of the medical commission that conducted a mandatory psychiatric examination (for individual company employees).

Which employees need to be checked by a psychiatrist? According to Part 6 of Article 213 of the Labor Code, employees undergo mandatory psychiatric examination at least once every five years:

Carrying out certain types of activities, including those associated with sources of increased danger (with the influence of harmful substances and adverse production factors);

Working in high-risk environments.

The list of medical psychiatric contraindications for carrying out certain types of professional activities and activities associated with a source of increased danger was approved by Decree of the Government of the Russian Federation dated April 28, 1993 No. 377.

The result of the employee's medical examination. Upon completion of the employee’s medical examination, the medical organization issues a medical report in two copies:

One copy of the report is given to the employee;

The second remains in the medical organization (clause 31 of the Procedure for undergoing medical examinations).

Final Act

Within 30 days after completion of the medical examination of employees, the medical organization draws up a final report.

Within five days after its approval, the medical organization sends one copy of the report to the company (clauses 42 and 43 of the Procedure for undergoing a medical examination).

The employee submits a medical report

A medical report serves several functions. It confirms that the employee has undergone a mandatory medical examination.

If the medical examination does not reveal any abnormalities, the employee can continue his work based on the medical report.

If an employee, for health reasons, cannot perform work in his specialty, the employer must offer him another job that corresponds to his state of health and qualifications, and in its absence or the employee refuses to transfer, dismiss the employee (clause 8 of article 77 of the Labor Code RF).

It is advisable to oblige employees to bring original medical reports and make copies of them. Such an obligation can be prescribed in the order for referral for a medical examination (a sample is given above).

The employee did not undergo a medical examination

If an employee does not pass or refuses to undergo a medical examination, the employer is obliged not to allow him to perform his job duties or to suspend him from work (paragraph 13, part 2, article 212 and part 1, article 76 of the Labor Code of the Russian Federation).

As a general rule, wages are not accrued during suspension from work (preclusion from work). However, exceptions are provided, for example, the period of suspension from work is paid as idle time (Part 3 of Article 76 and Article 157 of the Labor Code of the Russian Federation), if the employee has not undergone a mandatory medical examination:

Due to the fault of the employer - the period of suspension is paid in the amount of 2/3 of average earnings;

For reasons beyond the control of the employer and employee - 2/3 of the salary.